Meningitis is an inflammation of the membranes that surround the brain and spinal cord. It can be caused by bacteria, viruses, fungi or parasites. Some forms are mild and resolve on their own. Others can kill within hours.

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The World Health Organisation estimates around 2.5 million cases of meningitis occur globally each year, with children under five carrying the highest burden. Bacterial meningitis is the most dangerous form. Even with treatment, it can be fatal. And roughly one in five survivors are left with lasting complications like hearing loss, brain damage or learning disabilities.

This is one of those conditions where knowing the signs could genuinely save a life.

What does meningitis look like in adults?

The most well-known symptoms of bacterial meningitis are a high fever, a stiff neck and a severe headache. You might also notice confusion or a change in mental state. But here is the important thing. All three of these classic signs appear together in fewer than half of confirmed cases.

Other symptoms to watch for include sensitivity to light, sensitivity to loud noise, nausea and vomiting, drowsiness and a rapidly spreading rash of small purple or red spots.

That rash is particularly associated with meningococcal meningitis, one of the most serious forms. The spots do not fade when you press a glass against them. This is known as the glass test, and it should always be treated as an emergency.

Around a quarter of adults with bacterial meningitis also have an ear or sinus infection that may have been the original source of the bacteria.

What does meningitis look like in babies and young children?

This is where things become especially difficult. Babies and toddlers often do not show the classic symptoms. Neck stiffness is frequently absent, and a young child obviously cannot tell you they have a headache.

Instead, the signs to look for include irritability that is hard to console, a high-pitched or unusual cry, poor feeding or refusing feeds, lethargy or floppiness, a bulging fontanelle (the soft spot on the top of a baby’s head), fever or unusually low body temperature and signs of breathing difficulty.

Seizures occur in around 40 percent of children with bacterial meningitis, usually in the first few days. In some cases, particularly if a child has recently taken antibiotics for another infection, a seizure may be the only presenting symptom.

Trust your instincts. If your child is behaving unusually and deteriorating quickly, do not wait.

What is the difference between viral and bacterial meningitis?

Not all meningitis is the same, and understanding the difference matters.

Viral meningitis is the more common form. It is unpleasant but usually resolves on its own within seven to ten days. Symptoms tend to develop over a day or two and include fever, headache, sensitivity to light, nausea, vomiting and a stiff neck. You might also notice muscle aches, tiredness and a general feeling of being unwell before the neurological symptoms appear.

The key difference is that people with viral meningitis generally look less seriously ill. Mental function is usually normal or only mildly affected, and the illness often follows a two-phase pattern with initial flu-like symptoms followed by meningeal signs.

Bacterial meningitis progresses much faster. Patients can go from feeling slightly unwell to critically ill within hours. They often appear visibly toxic and may deteriorate rapidly.

If there is any doubt about whether it is viral or bacterial, it should always be treated as bacterial until proven otherwise. This is a situation where speed matters more than certainty.

When to call 999

The non-blanching rash is one of the most recognisable warning signs. Press a clear glass firmly against the skin. If the rash does not fade, call 999 immediately.

But not every case of meningitis produces a rash. Waiting for one to appear before seeking help could be a dangerous delay.

Any combination of high fever, severe headache, neck stiffness, confusion, sensitivity to light and vomiting in an otherwise well person should be treated as a medical emergency. In babies, look for the signs mentioned above and act fast.

Which vaccines protect against meningitis?

There is no single vaccine that covers every cause of meningitis. But several vaccines now offer strong protection against the most common and most dangerous bacterial forms. Here is what is currently available in the UK.

The MenB vaccine

Meningococcal group B bacteria are the most common cause of bacterial meningitis in the UK. The MenB vaccine (Bexsero) was added to the NHS routine childhood schedule in 2015 and has been a game-changer.

As of July 2025, the schedule was updated so that babies now receive the vaccine at 8 weeks, 12 weeks and 12 months. The second dose was brought forward from 16 weeks after data showed that cases were increasingly affecting very young babies who had not yet received their second jab.

In its first three years, the programme prevented an estimated 277 cases and achieved a 75 percent reduction in MenB disease among fully vaccinated age groups.

The MenACWY vaccine

This vaccine protects against four types of meningococcal bacteria. It is offered to teenagers around the age of 14 and remains available for anyone up to the age of 25 who missed it.

It is particularly important for young people heading to university, where close-living environments increase the risk of transmission. It is also recommended for travellers to high-risk regions, including those undertaking the Hajj and Umrah pilgrimages.

The pentavalent meningococcal vaccines

One of the most significant developments in recent years has been the approval of pentavalent vaccines that combine protection against all five major meningococcal serogroups (A, B, C, W and Y) in a single product.

Two pentavalent vaccines are now approved in the United States. Penbraya (Pfizer) was recommended in 2023, and Penmenvy (GSK) was licensed in February 2025. These are currently approved for those aged 10 to 25 and are not yet part of routine UK schedules, but they represent a promising step toward simpler and broader protection.

Other vaccines that help prevent meningitis

Several other routine childhood vaccines also play a role in preventing meningitis. The 6-in-1 vaccine protects against Haemophilus influenzae type b (Hib), which was historically a major cause of childhood meningitis. The pneumococcal vaccine guards against pneumococcal meningitis. And the MMR vaccine helps prevent measles, mumps and rubella, all of which can cause meningitis as a complication. From January 2026, the UK replaced MMR with the MMRV vaccine, which also covers chickenpox.

The BCG vaccine

The BCG vaccine, which protects against tuberculosis, also provides good protection against TB meningitis. It is offered to babies and children considered at higher risk in the UK.

Are meningitis vaccines safe?

Yes. Meningitis vaccines are extensively tested before licensing and are continuously monitored after they are introduced. Side effects are generally mild and short-lived. The most common reactions include soreness at the injection site, a mild fever and irritability in babies.

After MenACWY vaccination, any side effects usually last one to two days. After MenB or pentavalent vaccination, they may last three to five days. Serious adverse reactions are rare.

Given that bacterial meningitis can be fatal even with treatment, the benefit of vaccination far outweighs the risk.

What is the UK doing to defeat meningitis?

The UK has one of the most comprehensive meningitis vaccination programmes in the world, and it continues to evolve. The July 2025 schedule changes brought the second MenB dose forward to provide earlier protection for the youngest and most vulnerable babies. The Hib/MenC combination vaccine was discontinued after the success of the MenACWY programme in reducing meningococcal infections across all age groups.

Globally, the WHO’s Defeating Meningitis by 2030 roadmap sets out ambitious targets. These include eliminating bacterial meningitis epidemics, halving vaccine-preventable cases, reducing deaths by 70 percent and improving quality of life for survivors. In April 2025, the WHO published its first-ever global guidelines on meningitis diagnosis, treatment and care.

The bottom line

Meningitis remains a serious and sometimes fatal illness, but vaccination has dramatically reduced its impact. If you or your child are due for any meningitis-related vaccine, please do not delay.

And regardless of vaccination status, knowing the symptoms is critical. Meningitis can still occur from causes not covered by current vaccines.

If someone is rapidly deteriorating with fever, headache, neck stiffness, confusion or a non-blanching rash, call 999 without hesitation. In meningitis, time is everything.

If you would like to arrange a GP consultation to discuss symptoms get in touch with our team at team@thewellnesslondon.com

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